鼓室成形術の一変法—正円窓コルメラ法

REVERSE COLUMELLA: A METHOD OF TYMPANOPLASTY

　I．はじめに

　鼓室成形術は第二次大戦後の耳鼻咽喉科領域の中でもつとも画期的な発展をした手術方法の一つである。幾多の改良が試みられ，理論的に手術術式として，ほぼ完成^{12）13）23）24）}されたが，なお，個々の臨床経験^{4）6）7）21）}は，鼓室成形術にも，聴覚理論にも，何らかの知見を与える余地を有すると思われる。

　私どもは，この度，聴力改善のため鼓室成形術を行ない正円窓にコルメラを当てるreverse columella法を行なつた結果，聴力の改善をみたのでsonoinversionの一症例として報告する。

　A man, aged 30, complained of poor hearing in spite of an intact tympanic membrane following the initial tympanoplasty. In order to overcome this difficulty, a second operation was decided upon. It was revealed the stapes area to be surrounded by hard granulation tissues. These were removed. Type Ⅲ Wullstein procedure was performed. But still no improvement in hearing occurred. However, with insersion of columella at the round window a sudden improvement of hearing was obtained.

　Eight months after the latter procedure the patient has an average of 30 db hearing improvement without any sign of deterioration.